Fri Dec 31 2021

45 articles - From Saturday Dec 25 2021 to Friday Dec 31 2021

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews

Rheumatology (Oxford)

Comment on: Cardiovascular events in adult polymyositis and dermatomyositis: a meta-analysis of observational studies.

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Comment on: Cardiovascular events in adult polymyositis and dermatomyositis: a meta-analysis of observational studies: Reply.

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Studies

RCT, clinical trials, retrospective studies, etc…

Ann Rheum Dis

Large-scale analysis of longitudinal skin gene expression in systemic sclerosis reveals relationships of immune cell and fibroblast activity with skin thickness and a trend towards normalisation over time.

Skin thickness in SSc is related to dysregulated immune cell and fibroblast gene expression. Skin gene expression changes over time in early diffuse SSc, with a tendency towards normalisation. These observations are relevant for understanding SSc pathogenesis and could inform treatment strategies and clinical trial design.

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Arthritis Care Res (Hoboken)

Evaluating the construct of damage in systemic lupus erythematosus.

We identified shifts in the paradigm of SLE damage and developed a unifying conceptual framework. These data form the groundwork for the next phases of SDI development.

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Health literacy and appropriateness of self-care and pain management in osteoarthritis: An understanding of the patient's perspective.

Appropriate selection and use of evidence-based management options is critical for patients with OA to obtain the full benefits from their treatment. Knowledge about suitable choices for OA self-care is sub-optimal and future education should be tailored to different levels of HL.

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Hydroxychloroquine Use and Cardiovascular Events Among Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis.

In this nested case-control study of patents with SLE and RA, we found a reduced risk of overall CV events associated with current HCQ use including reductions in VTE and trends towards reductions in MI and stroke. These findings suggest a possible cardiovascular preventative benefit of HCQ use.

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Motivators, Barriers, and Opportunity for E-Health to Encourage Physical Activity in Axial Spondyloarthritis: A Qualitative Descriptive Study.

The results of this study provide a foundation to guide development of patient-centered e-health technology interventions to increase physical activity uptake in patients with axial SpA.

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Arthritis Res Ther

CTLA4-Ig treatment induces M1-M2 shift in cultured monocyte-derived macrophages from healthy subjects and rheumatoid arthritis patients.

CTLA4-Ig treatment seems to induce the in vitro shift from M1 to M2 macrophages, of both HS-M1-MDMs and RA-MDMs, as observed by the significant downregulation exerted on selected M1 markers and the upregulation of selected M2 markers suggesting an additional mechanism for its modulation of the RA inflammatory process.

Pubmed   Journal   ReadQx   PMC

Arthritis Rheumatol

B cell numbers predict humoral and cellular response upon SARS-CoV-2 vaccination among patients treated with rituximab.

In patients receiving RTX, a minimum of 10 B cells/µl in the peripheral circulation candidates as biomarker for a high likelihood of an appropriate cellular and humoral response after SARS-CoV-2 vaccination. Mechanistically, the data emphasize the crucial role of co-stimulatory B cell functions for the proper induction of CD4 responses propagating vaccine-specific B and plasma cell differentiation.

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Diastolic Dysfunction in Systemic Sclerosis: Risk Factors and Impact on Mortality.

DD is independently associated with an increased risk of mortality in patients with SSc. Potentially modifiable risk factors, including CAD and obesity, should be addressed in patients with SSc to reduce mortality risk.

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Extramucosal formation and prognostic value of secretory antibodies in rheumatoid arthritis.

Circulating secretory immunoglobulins are elevated before and at RA onset. In the presence of free SC, secretory immunoglobulins may form outside the mucosa, and SC ACPA are enriched in RA joints. These findings shed important new light on the mucosal connection in RA development.

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Impact of cytokine inhibitor therapy on the prevalence, seroconversion rate and longevity of the humoral immune response against SARS-CoV-2 in an unvaccinated cohort.

IMID patients treated with bDMARDs have a lower prevalence of SARS-CoV-2 antibodies, seroconvert less frequently after SARS-CoV-2 infection and may exhibit a reduced longevity of their humoral immune response.

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Intensive serum urate lowering with oral urate-lowering therapy for erosive gout: A randomized double-blind controlled trial.

OMERACT core outcome domains (gout flares, tophus, pain, patient global assessment, health-related quality of life, and activity limitation) improved in both groups, with no between-group differences. Adverse event and serious adverse event rates were similar between groups. Compared with a serum urate target below 0.30mmol/L, more intensive serum urate-lowering is difficult to achieve with oral ULT, leads to high medication burden, and does not improve bone erosion scores in erosive gout.

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Interleukin-1-ß-Activated Microvascular Endothelial Cells Promote DC-SIGN+ Alternative Macrophages Associated with Skin Fibrosis in Systemic Sclerosis.

Our work sheds new light on the vicious circle implicating IL-1ß unabated secretion, microvascular endothelial cells activation and generation of DC-SIGN + AAM in fibrosis during scleroderma.

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Rituximab impairs B-cell response but not T-cell response to COVID-19 vaccine in auto-immune diseases.

RTX induced diminished antibody response to mRNA COVD-19 vaccine, but the functional T-cell response was not altered compared to HC and AID patients treated with other IS. Further work is needed to assess the clinical protection granted by a functionally active T-cell response in the absence of an anti-spike antibody response.

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The Contribution of the Interleukin-4-Induced Epithelial Cell Senescence to Glandular Fibrosis in IgG4-Related Sialadenitis.

Furthermore, injecting IL-4 promoted fibrosis and senescence phenotypes in the SMGs in vivo. The cellular senescence induced by IL-4 through the ROS-p38 MAPK-p16INK4A pathway promoted fibrogenesis during IgG4-RS. Our data suggest that cellular senescence could serve as a novel therapeutic target for treating IgG4-RS.

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Rheumatology (Oxford)

Characterization and associated risk factors of Pneumocystis Jirovecii Pneumonia in patients with AIRD: A retrospective study.

AIRD patients with high-dose GC treatment, recent initiation of IST, combination therapy with CsA, and history of chronic pulmonary diseases were associated with greater risks of PJP infection. PJP patients with a higher level of serum LDH, dyspnea, moderate and severe ARDS, and the presence of extensive GGO in radiologic examinations had poorer prognosis.

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Clinical picture, outcome, and predictive factors of lymphoma in primary Sjogren's syndrome. Results from a harmonized dataset (1981-2021).

Common features of pSS, present at diagnosis, can predict future lymphomagenesis meriting a more intensive follow up plan.

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Efficacy and safety of belimumab during maintenance therapy in patients with systemic lupus erythematosus.

The present study suggests that BEL is suitable for patients with SLE during maintenance therapy.

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Emergence of New Manifestations During Infliximab Treatment in Behçet Syndrome.

New manifestations developed during IFX treatment in 7% of our patients with BS. They could be managed by intensifying IFX treatment or adding other agents in majority of these manifestations.

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European bio-naïve spondyloarthritis patients initiating TNFi: Time trends in baseline characteristics, treatment retention and response.

Our findings indicate that over the past decades, clinicians have implemented more aggressive treatment strategies in spondyloarthritis. This was illustrated by shorter disease duration at treatment initiation, decreased retention rates and higher remission rates during recent years.

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Fatigue in Early Rheumatoid Arthritis: Data from the Early Rheumatoid Arthritis Network.

Fatigue is prevalent and persistent in early RA. Diverse characteristics indicative of central mechanisms are associated with persistent fatigue. Management of fatigue might require interventions targeted at central mechanisms in addition to inflammatory disease modification. People who require such interventions might be identified at presentation with early RA.

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Features of non-Hodgkin's lymphoma diagnosed in minor salivary gland biopsies from primary Sjögren's syndrome patients.

For pSS patients with suspected NHL, mSGB histology enabled NHL diagnosis in half of them, MALT was found in 95.8% and al mSGBs+ were MALT lymphomas, thereby avoiding more invasive biopsy. Our results suggest that mSGB should be obtained at pSS diagnosis and repeated during follow-up, when NHL is suspected.

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Immune thrombocytopenia with clinical significance in systemic lupus erythematosus: a retrospective cohort study of 90 patients.

Four patients experienced thrombotic events after splenectomy and one occurred under thrombopoietin-receptor agonist treatment. SLE-ITCS patients displayed a high rate of haematological abnormalities and MBG patients exhibited higher morbidity. Management of thrombocytopenia was highly heterogeneous and many options seem viable.

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Increased risk of thoracic aortic complications among patients with giant cell arteritis: a nationwide, population-based cohort study.

Among GCA patients, female sex, age below 70 years and positive temporal artery findings were risk factors for developing thoracic AA. The median time to thoracic AA was 7.5 years (interquartile range 4.4-11.2) with a number needed to be screened of 250 (167-333), 91 (71-111) and 53 (45-67) after 5, 10 and 15 years. Patients with GCA have a markedly increased risk of developing thoracic AA and AD, but no increased risk of abdominal AA.

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Integrating imaging and biomarker assessment to better define psoriatic arthritis and predict response to biologic therapy.

Excess adipose tissue makes if more difficult to detect joint swelling clinically, as many PsA patients have very high BMIs. Integrating imaging and clinical assessment with biomarker analysis could help to deliver stratified medicine in PsA and allow better treatment decision making. This could include which patients require ongoing biologic therapy, which class of biologic therapy that should be, and who alternatively requires management of non-inflammatory disease.

Pubmed   Journal   ReadQx   PMC

Intravenous immunoglobulin for interstitial lung diseases of anti-melanoma differentiation-associated gene 5-positive dermatomyositis.

IVIG adjunct therapy is a very effective first-line treatment for patients with MDA5-RPILD. IVIG may increase the survival and remission rate by lowering ferritin concentration, anti-MDA5 titer and GGO score.

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New developments in ankylosing spondylitis-status in 2021.

This failure has raised theories for a degree of IL-23 independent pathway. The Janus kinase (JAK) pathway is also a potential therapeutic target, since several cytokines, including those involved in the IL-23-IL-17 axis, signal through the JAK family of tyrosine kinases. Further studies and more extended evaluation of response to cytokine inhibition across different tissues will be required to improve our understanding of SpA pathogenesis and determine its optimal management.

Pubmed   Journal   ReadQx   PMC

New developments in osteoarthritis pharmacological therapies.

Anti-IL-6 and anti-GM-CSF also did not improve symptoms in hand OA trials, but IL-1 remains an intriguing target for large-joint OA, based on reduced joint replacements in a post hoc analysis from a large cardiovascular disease trial. The peripheral nociceptive pathway appears an attractive target, with mAbs to nerve growth factor and IA capsaicin demonstrating efficacy; tropomyosin receptor kinase A inhibitors are at an earlier stage of development. Limited evidence suggests pharmacological therapies can modify cartilage and bone structural progression, though evidence of synchronous symptom benefits are lacking.

Pubmed   Journal   ReadQx   PMC

New developments in Sjogren's syndrome.

B-cell depletion is used in patients with systemic disease but its overall clinical efficacy has not been demonstrated in two large randomized controlled trials. Studies are now focussing on alternative strategies to target B-cells, including co-stimulation targets, with promising data. It is increasingly clear that clinical trials in SS will require patient stratification and relevant and sensitive outcome measures to identify successful treatment modalities.

Pubmed   Journal   ReadQx   PMC

New developments in systemic lupus erythematosus.

Other therapeutics aim to restore immunological balance by restoring tolerance. Results from phase II and even phase III trials are promising and it is likely that some of the therapeutics discussed will receive approval in the following years. Hopefully, this will allow for more tailor-made medicine for SLE patients in the future.

Pubmed   Journal   ReadQx   PMC

Obinutuzumab as Treatment for ANCA-Associated Vasculitis.

Obinutuzumab appears to be a safe and efficacious therapy for patients with ANCA-associated vasculitis who have had refractory disease or a history of anaphylaxis to rituximab. Prospective studies comparing rituximab to obinutuzumab in ANCA-associated vasculitis patients are warranted.

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Recent progress in treatments of rheumatoid arthritis: an overview of developments in biologics and small molecules, and remaining unmet needs.

Five JAK inhibitors show comparable efficacy to bDMARDs, and the latest ones are effective for overcoming difficult-to-treat RA regardless of prior medications. Patients treated with JAK inhibitors should be adequately screened and monitored for infection, cardiovascular disorders, thrombosis, malignancies and so on. Advances in therapeutic strategies, including the differential use of therapeutic drugs and de-escalation of treatment after remission induction, are prioritized.

Pubmed   Journal   ReadQx   PMC

Screening and management of subclinical interstitial lung disease in systemic sclerosis: an international survey.

Mycophenolate mofetil was the preferred first-line drug for the treatment of subclinical SSc-ILD. This international survey highlights important regional variations in SSc-ILD screening and significant heterogeneity among rheumatologists and respirologists in the treatment of subclinical SSc-ILD. High-quality research addressing these questions is needed to produce evidence-based guidelines and harmonize the approach to identification and treatment of subclinical SSc-ILD.

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T helper cells expressing fractalkine receptor and bearing T follicular helper 1-like cell functions in patients with IgG4-related disease.

CX3CR1+ CD4+ T cells characteristically increased in the peripheral blood and the affected tissues and were associated with an increase in the serum IgG4 levels of patients with IgG4-RD. This CD4 subset has a Th1/Tfh-like phenotype and a B cell helper function.

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The occurrence of multiple treatment switches in axial spondyloarthritis. Results from five Nordic rheumatology registries.

In this large Nordic observational cohort of axSpA patients, multiple switching was frequent with no apparent time-trend. Clinical associated factors included gender, but also previous comorbidities and extraarticular manifestations illustrating the ongoing challenge of treating this patient group.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Arthritis Rheumatol

Fanning the Flames of Autoimmunity: The Microbiome in Rheumatic Disease.

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Letters&Replies

Letters to the editors and authors’ replies

Arthritis Rheumatol

Conflicting reports of anti-NT5C1a autoantibodies in juvenile myositis: Comment on the article by Rietveld et al.

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Extensive Bone Marrow Capillary Network Masquerades as Fungal Hyphae in a Patient with Systemic Lupus Erythematosus.

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Others

all remaining publications eg case reports, images of the month, etc…

Ann Rheum Dis

Hypoglycaemia following JAK inhibitor treatment in patients with diabetes.

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Rheumatology (Oxford)

Comment on: Prevalence of gastrointestinal, cardiovascular, autonomic and allergic manifestations in hospitalized patients with Ehlers-Danlos syndrome: a case-control study.

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Comment on: Prevalence of gastrointestinal, cardiovascular, autonomic and allergic manifestations in patients with Ehlers-Danlos syndrome. Reply.

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Groove sign in a child.

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Recurrent perirenal hematomas and brachial plexopathy in a boy with familial Mediterranean fever associated polyarteritis nodosa.

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Therapeutic potential of the interleukin-4/interleukin -13 inhibitor dupilumab for treating IgG4-related disease.

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